Please initial each of the items below to acknowledge your understanding about the procedures and its inherent risks and benefits.

DESCRIPTION OF PROCEDURE: Microneedling treatment allows for controlled induction of the skin’s self-repair mechanism by creating micro-“injuries” in the skin, which triggers new collagen synthesis, yet does not pose the risk of permanent scarring. The result is smoother, firmer and younger-looking skin.

Microneedling procedures are performed in a safe and precise manner with the use of the sterile needle head. The procedure is normally completed within 30–60 minutes, depending on the required treatment and anatomical site.

SIDE EFFECTS: After the procedure, the skin will be red and flushed in appearance in a similar way to moderate sunburn. You may also experience skin tightness and mild sensitivity to touch on the area being treated. This will diminish greatly after a few hours following treatments and within the next 2 to 7 days the skin will be completely healed. It is normal to experience dryness and peeling.  

Contraindications: Micro-needling treatment is contraindicated for patients with: keloid scars, scleroderma, collagen vascular diseases or cardiac abnormalities, a hemorrhagic disorder or hemostatic dysfunction, active bacterial or fungal infection.

Precautions and Warnings: Microneedling treatment has not been evaluated in the following patient populations, as such, precautions should be taken when determining whether to treat: scars and stretch marks less than one year old; women who are pregnant or nursing; keloid scars; patients with history of eczema, psoriasis and other chronic conditions; patients with a history of actinic (solar) keratosis; patients with history of herpes simplex infections; diabetics or patients with wound-healing deficiencies; patients on immunosuppressive therapy; and skin with presence of raised moles or warts or targeted area.

I understand that results will vary among individuals.

I understand that although I may see a change after my first treatment, I may require a series of sessions to obtain my desired outcome.

I am advised that though good results are expected, the possibility and nature of complications cannot be accurately anticipated and that, therefore, there can be no guarantee as expressed or implied either as to the success or other result of the treatment. I am aware that Microneedling treatment is not permanent, as natural degradation will occur over time.

The procedure and side effects have been explained to me including alternative methods, as have the advantages and disadvantages. I state that I have read (or it has been read to me) and I understand this consent and I understand the information contained in it.

I realize that with any cosmetic service, there may be risks which must be understood. I will be fully responsible for any and all results which may arise from these cosmetic services. I do hereby agree to hold Mojo Master, Inc. free from any and all claims or suits for damage, for injuries or complications resulting from any cosmetic service provided by Mojo Master, Inc.

I have had the opportunity to ask any questions about the treatment including risks or alternatives and acknowledge that all my questions about the procedure have been answered in a satisfactory manner. This consent form is valid until all or part is revoked by me in writing.

I acknowledge that any information contributed by me is true, to the best of my knowledge, and that the present condition of the area that has been treated or will be treated is stated on this record. I fully understand that Mojo Master, Inc. only provides cosmetic services; there is no medical treatment involved.

The nature and purpose of the cosmetic services, the risks involved, and the possibility of complications have been fully explained to me. I understand that no guarantee or assurance has been given by anyone as to the results that may be obtained

By signing below, I acknowledge that I have read and understand the above and all of my questions have been answered. I consent to receive the above cosmetic services.